How bad is bad behaviour by doctors? Worse than it appears, according to studies

Maybe it’s triggered from time to time by the buildup of stress that's, unfortunately, become a normal part of many a physician's workday. Or maybe—also unfortunate—that’s just how some doctors are. Whatever the reason, lapses of civil behaviour by doctors tend to draw a lot of attention, most likely because the effective practise of medicine relies heavily on relationships of trust.Just how bad is the problem of uncivilized behaviour by physicians? A recent article in the Canadian Medical Association Journal looked at the latest literature and found three out of four healthcare employees have witnessed uncivil behaviour from a doctor.Peer-to-peer incivility also appears to be common, with about three in 10 doctors saying they’ve been at the receiving end—on a weekly or daily basis—of dismissive or aggressive communication from their fellow doctors. But these numbers probably don’t tell the whole story, according to the CMAJ piece.“Prevalence (of physician incivility) varies and is likely underreported owing to nonstandardized definitions and heterogenous behaviour,” wrote the authors. Among residents, experiences with uncivil behaviour by doctors appear to be more frequent for those who bear certain characteristics. For example residents who are junior trainees, younger than 30 years old, shorter than 173 centimetres, female, part of an ethnic minority or are non-native language speakers report higher rates of experiencing physician incivility.Read: Oh behave! What bad behaviours do docs exhibit in the workplace?The article linked physicians’ bad behaviour in the workplace with high workloads, inadequate resources, communication problems and team-related challenges, including poor team cohesion, unfamiliarity with other members of the group and friction between the various disciplines. However among doctors who consistently behave in ways that are disruptive to the workplace, part of the root cause may be ongoing mental health challenges, wrote the authors.Regardless of what the triggers may be, uncivil behaviour by physicians should not be accepted.“Incivility by physicians is associated with poor patient outcomes, adverse effects on healthcare professionals and high organizational costs,” wrote the authors. “Disruptive behaviour diverts attention away from patient care, diminishes team collaboration and is associated with medication errors, patient neglect, surgical complications and death.”At the same time, the authors added, “healthcare team members experiencing incivility have decreased well-being, increased burnout, higher rates of absenteeism and premature departures.”Read: My tips on how to avoid burnout as a surgeonWhile it didn’t point a finger at who should be responsible for addressing the problem of physician incivility in the workplace, the article did underline the dangers of accepting incivility as “inevitable in a stressful environment or excusable in ‘high-value’ physicians.”This acceptance perpetuates the behaviour, including among learners who are more likely to exhibit incivility after they’ve been exposed to it.“Successful interventions for disruptive physicians include individual coaching and therapy,” wrote the authors. “Structured approaches to improve emotional intelligence, introspection, conflict resolution, leadership and mindfulness have led to positive behaviour changes in the clinical environment.”Read: Stopping microaggressions in the clinical learning environment

How bad is bad behaviour by doctors? Worse than it appears, according to studies

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